12.1 Monitoring and evaluation are part of a national drug policy

Monitoring and evaluation are also important elements of the national drug policy, and a monitoring and evaluation system should be set up with the necessary staff and an operating budget. The subject has already been discussed as part of the national drug policy process. Some components which need to be included in the drug policy itself (and in the master plan) are briefly summarized here. More details and references are given in Section 2.4.

Why are monitoring and evaluation important?

A system for monitoring and evaluation is a constructive management tool that enables an ongoing assessment of progress, and contributes to the necessary management decisions. It also provides transparency and accountability, and creates a standard by which comparisons can be made between countries, between areas and over time. All of this may produce the necessary evidence that progress is being made (or not), in order to support the policy in discussions with interested parties and policy-makers.

It is a challenge to create and maintain good systems of monitoring and evaluation. Apart from a lack of time, human resources and budget, there is often a basic lack of understanding of the value of monitoring in the first place, and resistance to objectively or critically reviewing the effects of activities formulated in the master plan.

Monitoring national drug policies

To determine whether adequate progress is being achieved with the various components of the drug policy or the master plan, it is helpful to set realistic targets or performance standards. Indicators can be selected and used to measure progress towards the targets, and to make comparisons over time or between countries and areas. The indicators should be clear, useful, measurable, reliable and valid. Information on indicators for monitoring national drug policies has been given in Section 2.4.

It is recommended that early in the implementation of the national drug policy a baseline survey that covers the whole country is carried out. This baseline can be used as the starting point for setting targets. Baseline surveys in each of the provinces or regions help to involve regional policy-makers and staff, create awareness of problems in the pharmaceutical sector, and may point to regional differences in performance and resources. Repeated regional or national surveys have yielded very useful information in support of managerial or policy decisions.

Periodic evaluations of the national drug policy

The national drug policy as a whole should also be periodically evaluated, preferably every two to three years. Progress can be measured against the initial baseline survey. Independent consultants or professionals from other countries or from WHO may be invited to complement a national evaluation team. Such periodic evaluations should form an integral part of the pharmaceutical master plan, with the necessary resources allocated from the start.